Individual provider Active NPI

Mary Jose Zamora Lopez

  • General Practice Physician
  • Mayaguez, PR
National Provider Identifier
1841604170
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
021240 Issued in PR
Practice address
22 Ave Los Maestros
Mayaguez, PR 00682-5952
Phone
(787) 833-7434
NPI assigned
Jun 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X
General Practice Physician 208D00000X 021240 PR Primary

Addresses

Primary practice location

22 Ave Los Maestros
Mayaguez, PR 00682-5952

Mailing address

22 Ave Los Maestros
Mayaguez, PR 00682-5952
Phone (787) 833-7434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210127002237 PR Practitioner - General Practice 9537573803 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
021240PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Migrant Health Center Western Region, Inc. CurrentSince Jan 11, 2021 Accepting new patients
Migrant Health Center Western Region,Inc CurrentSince Jan 11, 2021 Accepting new patients
Migrant Health Center Western Region, Inc. Past Accepting new patients

Locations

183 Ave Dunscombe
Mayaguez, PR 00682
Phone (787) 613-6918

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1841604170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 AVE LOS MAESTROS",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006825952",
            "telephone_number": "787-833-7434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 AVE LOS MAESTROS",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006825952",
            "telephone_number": "787-833-7434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMORA LOPEZ",
        "first_name": "MARY JOSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-14",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "021240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.